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Children, Adolescents, and Young Adults

New Reports Must Lead to Transformations

Two reports—one released this month and one scheduled for the fall—highlight critical dimensions for the child and adolescent mental healthcare system and transitions to adulthood.

GAO Report Leads to Legislation

On June 25, the U.S. Government Accountability Office (GAO) released the report Young Adults with Serious Mental Illnesses: Some States and Federal Agencies are Taking Steps to Address Their Challenges” (GAO-08-678).

"Under the best of circumstances, the transition years from adolescence to adulthood are rarely easy. They are infinitely harder for young adults, ages 18 to 26, who live with illnesses such as schizophrenia and bipolar disorder," said NAMI executive director Michael J. Fitzpatrick. "Transitions are made even more difficult by the separation and differences that exist between the nation’s child and adolescent and adult mental health care systems."

The GAO report estimates that 2.4 million young Americans living with mental illnesses fall within transition ages, but the estimate does not include young adults funneled into the criminal justice system, institutionalized or living homeless on the streets.

Legislation in Congress was introduced the same day due in part to the work of NAMI’s Child & Adolescent Action Center —seeking to build a national foundation for transitions to adulthood through state planning grants.

"We need a 50-state strategy to provide life skills, education, housing, supported employment and other services that can serve as a foundation for the future of young adults in transition who live with mental illness," Fitzpatrick said.

Unclaimed Children Report Coming This Fall

On June 16 at the NAMI national convention, the National Center for Children in Poverty discussed planning for release of a major report on the status of children’s mental healthcare services in November 2008 at the Carter Center in Atlanta.

More than 25 years ago, Dr. Jane Knitzer of Columbia University published a landmark study, Unclaimed Children: The Failure of Public Responsibility to Children and Adolescents in Need of Mental Health Services, which called attention to dire conditions in a fragmented, unregulated system.  The November report will provide an important, comprehensive and influential update.

Gary Blau, M.D., chief of the Child, Adolescent, and Family Branch of the Center for Mental Health Services (CMH) inside the federal government’s Substance Abuse & Mental Health Services Administration (SAMHSA), emphasized the importance of leadership in transforming the systems.

"If you’re not living on the edge, then you are taking up too much space," he said, as he outlined SAMHSA’s efforts to "accelerate the work" in transforming systems of care on a national scale.

SAMHSA’s prescription for child and adolescent mental healthcare programs rests on principles of services that are individualized, family focused, culturally competent, community based, accessible, provided in the least restrictive environment, and through collaborative, coordinated interagency networks—all of which reflect NAMI’s own values.

Blau noted that SAMHSA has partnered with NAMI "more than ever before" in recent years in developing children’s mental health initiatives.

As part of the challenge facing NAMI and SAMHSA, Blau noted the fact that it can take 18 years from the initial development of evidence-based practices to achievement of widespread acceptance and use. Sustained leadership and focus over time is essential. 

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